Objectlve investigate the role of Toll-like receptor 2 (TLR2) on polymorphonuclear neutrophil (PMN) during perioperative period in the development of postoperative systemic inflammatory response syndrome (SIRS) in patients undergoing orthotopic liver transplantation (OLT).Methods Twenty patients (18 male and 2 female, aged 33-58 yr and weighing 52-73 kg) with ASA Ⅲ or Ⅳ (NYHA Ⅱ or Ⅲ )undergoing OLT were studied. Blood samples were collected from the central vein for determination of TLR2 expression on PMN and plasma TNF-α, IL-1β and IL-8 concentrations before induction of anesthesia (T1, baseline), at 25 min of anhepatic phase (T2), 3 h (T3) and 24 h after beginning of reperfusion of the allograft (T4). The expression of TLR2 was measured by flow cytometry and the serum concentrations of TNF-α, IL-1β and IL-8 were measured by enzyme linked immunosorbant assay (ELISA). The patients were divided into SIRS and non-SIRS group depending on whether the patients developed SIRS or not within 7 days after operation. The diagnosis of SIRS was based on the criteria laid down by ACCP and SCCM in 1992.Results Ten patients developed SIRS within 7 days after operation. There was no significant difference in Child-Turcotte-Pugh (CTP) scores between the two groups. Compared with non-SIRS group, the TLR2 expression on PMN and the serum IL-1β concentration were significantly increased at T4 and the serum IL-8 concentration was significantly increased at T3 in SIRS group.There was positive correlation between serum TNF-α concentration and TLR2 expression on PMN in SIRS group ( r= 0.607, P ＜0.05).Conclusion The expression of TLR2 on PMN increases significantly at 24 h after beginning of reperfusion of allograft and may play an important role in the development of postoperative SIRS.

Objective To disscuss and analyze the clinical effects of whole body mild hypothermia on MODS caused by cerebral hemorrhage.Methods One hundred and eighty patients with MODS caused by cerebral hemorrhage during the period of hospitalized from January 2013 to December 2015 in ICU of our hospital were divided into two groups (observation group and control group) randomly,90 cases patients in each group.Patients in control group were treated with conventional treatment intervention,patients in control group were treated with whole body mild hypothermia on the base of conventional treatment intervention,the score of MODS,the ratio of,VO2 and DO2,the time during the period of hospitalized in ICU,the time of mechanical ventilation,epilepsy incidence and mortality,NIHSS score and PADL score of the patients in these two group after treatment were compared.Results After the comparion,the score of MODS and the state of oxygen consumption and oxygen supply of the patients in observation group were better than the patients in control group,there was significant differences,and had statistical significance (P＜0.05);the time during the period of hospitalized in ICU and the time of mechanical ventilation of the patients in observation group were shorter than the patients in control group,there was significant difference,and had statistical significance (P＜0.05);the mortality were reduce significantly of the patients in observation group than the patients in control group,there was significant difference,and had statistical significance (P＜0.05);the epilepsy incidence of the patients in observation group and control has no significant difference,has no statistical significance (P＞0.05);the NIHSS score and PADL score of the patients in observation group were higher than the patients in control group,there was significant difference,and has statistical significance (P＜0.05).Conclusion The clinical effects of whole body mild hypothermia on MODS caused by cerebral hemorrhage have important significance,can effectively improve the balance of multiple organ dysfunction syndrome patients,can delay the progression of multiple organ dysfunction syndrome patients,improve the prognosis,it is worthy of clinical application and promotion.

Objective To explore the effects of human umbilical cord mesenchymal stem cells (HUC?MSCs) on podocytic apoptosis and injury induced by high glucose (HG) and the underlying mechanisms. Methods Podocytes were divided into six groups according to treatment: ⑴ normal glucose group (NG);⑵high glucose group (HG);⑶mannitol control group (NG+Ma);⑷HUC?MSC co?culture group (HUC?MSCs); ⑸ recombinant human hepatocyte growth factor treatment group (rhHGF);⑹ neutralizing antibody group(HGF?NtAb). Cytometry and Hoechst staining were used to detect the apoptosis rates. Western blot was used to measure the ratio of active PARP to total PARP and the level of Bcl?2. Immunofluorescence was used to study podocytic apoptosis and injury. Neutralizing antibody (NtAb) was used to block its function and the recombinant cytokine was added to induce its function. Results High glucose induced podocytic apoptosis in a time?dependent manner, HUC?MSCs co?culture decreased the podocytic apoptosis rate and the expression of PARP (all P﹤0.05), increased the expression of Bcl?2, prevented the reduced expression and maintained the normal arrangement of podocytic podoplanin. The rhHGF prevented podocytic apoptosis and injury similarly to HUC?MSCs, the beneficial effect of HUC?MSC decreased when blockade of HGF. Conclusions HUC?MSCs co?culture ameliorates podocytic apoptosis and injure induced by HG, probably through secreting soluble HGF.

Objective Gynecologic minimally invasive surgery has become popular in the treatment of tumor therapy in re-cent years, but improper application can result in tumor metastasis.In this paper, we presented 6 uterine neoplasm cases of tumor me-tastasis after minimally invasive surgery and analyzed the causes and the preventive measures. Methods Retrospective analysis was made on the clinical data and pathology characteristics of the 6 uterine neoplasm cases of tumor metastasis after primary minimally inva-sive surgery in our department from January 1, 2013 to 2015 June 30, and related literature were reviewed. Results The ages of 6 patients were 39-52 years old.The primary operation methods included 2 cases of hysteroscopic myomectomy, 3 cases of laparoscopic myomectomy and 1 case of radiofrequency ablation.The pathological diagnosis after primary operations were 4 cases of uterine sarcoma ( low grade endometrial stromal sarcoma in 2 cases and leiomyosarcoma in 2 cases) who were found metastatic tumor at 3-16 months after primary surgery and finally died of the disease and 2 cases of uterine fibroids who were found metastatic tumor in abdominal cavity and puncture hole at 60 months and 108 months respectively after primary operation followed by a good prognosis after the second surgi-cal resection. Conclusion Owing to uterine neoplasm by hysteroscopy, laparoscopy often needs certain pressure and morcellation which may result in easy plantation of crushing tumor tis-sue or metastasis with circulation and puncture under pressure.Ra-diofrequency ablation lack of histopathologic diagnosis has heating effect which is inclined to speed up the spread and transfer of tumor cells once it is diagnosed as malignant.Therefore, clinicians should know the defects and risk of being lack of histopathologic diagno-sis, diagnostic curettage pathology and fast pathology to avoid tumor metastasis induced by minimally invasive surgery.

Objective To discuss microvessel density (MVD) and expression of vascular endothelial growth factor(VEGF), androgen receptor(AR) in the prostates of men who received re-operation after TURP. Methods Fifty cases were performed re-TURP (re-TURP group) and the remaining 50 cases served as controls. 150 specimens were collected. Sections were stained for CD34 and VEGF, AR by immuno-histo-chemistry(S-P). Statistical analysis of the results was performed using t-test or Pearson Chi-Square test Results The expression of VEGF, AR and MVD were significantly higher in the re-TURP group compared to controls(P<0. 05),but in re-TURP group, difference in VEGF and AR expression as well as MVD were not found to be significantly different between the first and the second TURP(P>0.05). Conclusion Over expression of VEGF and AR as well as high MVD in prostatic tissue might play an important role in the pathological process of BPH after TURP.

Coronary artery disease (CAD) is a multifactorial disease in which inflammation plays a central role.This study aimed to investigate the association of inflammatory markers such as the neutrophil to lymphocyte ratio (NLR),the Global Registry of Acute Coronary Events (GRACE) score with in-hospital mortality of elderly patients with acute myocardial infarction (AMI) in an attempt to explore the prognostic value of these indices for elderly AMI patients.One thousand consecutive CAD patients were divided into two groups based on age 60.The laboratory and clinical characteristics were assessed retrospectively by reviewing the medical records.The NLR and GRACE score were calculated.In the elderly (≥60 years),patients with non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI) had significantly higher NLR than did those with unstable angina (UA) and stable angina pectoris (SAP) (P＜0.01).The NLR was considerably elevated in older AMI patients compared with their younger counterparts (＜60 years) (P＜0.05).In elderly AMI patients,the NLR was considerably higher in the high-risk group than in both the low-risk and medium-risk groups based on the GRACE score (P＜0.05 and P＜0.01,respectively),and the NLR was positively correlated with the GRACE score (r=0.322,P＜0.001).Either the NLR level or the GRACE score was significantly higher in the death group than in the surviving group (P＜0.05).By curve receiver operator characteristic curve (ROC) analysis,the optimal cut-off levels of 9.41 for NLR and 174 for GRACE score predicted in-hospital death [ROC area under the curve (AUC) 0.771 and 0.787,respectively,P＜0.001].It was concluded that an elevated NLR is a potential predictor of in-hospital mortality in elderly patients with AMI.

Objective To investigate the clinical factors influencing the treatment efficacy of microsurgery on patients with cerebral arteriovenous malformations (AVMs). Methods One hundred and eleven patients,admitted to our hospitals from January 1,2003 to December 31,2009 and underwent microsurgical cerebral AVMs resection were chosen in our study; their clinical data were retrospectively analyzed.The functional neurological status was classified with modified Rankin scale 7 d and 6 months after surgery. Binary logistic regression models were applied to test the effect of patient gender, age,intra-cerebral hemorrhage,and the size,deep venous drainage pattern and location of AVMs on long-term and short-term treatment efficacy. Results Twenty-nine patients (26.1％) showed new neurological deficits 7 d after the surgery.Univariate analysis and multivariate analysis demonstrated that deep venous drainage, eloquent location and large size of AVMs, high Spetzler-Martin grading aneurysms and no intra-cerebral hemorrhage were significantly associated with new early neurological deficits (P＜0.05),while gender and age of the patients had no significant association with new early neurological deficits (P＞0.05).The scores of neurological status scale in patients with Spetzler-Martin grading Ⅰ,Ⅱ and Ⅲ were significantly different between 7 d and 6 months after the surgery (P＜0.05). Conclusion AVMs patients having deep venous drainage,eloquent location and large size of AVMs,and having aneurysm and intra-cerebral hemorrhage may be the risk factors of new early neurological deficit after microsurgical resection; analyzing the Spetzler-Martin grading before surgery can help to determine the treatment options.

Objective To dynamically monitor the humoral immune parameters in the blood and cerebrospinal fluid and analyze the relationship between immunity and disease development and recovery after brain injury to explore the clinical effect of naloxone combined with mild hypothermia on the treatment of brain injury.Methods One hundred patients with severe craniocerebral injury admitted to our hospital from January 2008 to December 2008,were prospectively studied and equally divided into treatment group and control group.The control group was given conventional therapy,while the treatment group was given naloxone combined with mild hypothermia besides conventional therapy.We detected the changes of the contents of IgG,IgA,IgM,complement c3 and albumin in the blood and cerebrospinal fluid on the 4th,14th,and 21st d of injury.Then we compared the differences between the humoral immune parameters and both the clinical infection rates and the disability grades in the 2 groups.Results No statistical significance in the immune indexes of blood and the IgM content of cerebrospinal fluid was found between the control group and the treatment group (P>0.05),while statistical significances in the changes of the contents of IgG,IgA,IgM and albumin in the cerebrospinal fluid,the clinical infection rates and the disability grades were found between the 2 groups (P<0.05).The positive rate of complement c3 in the cerebrospinal fluid was statistically significant between the 2 groups on the 4th d of injury (P<0.05).Conclusion Naloxone combined with mild hypothermia has definite curative effect and no obvious adverse reaction in treating patients with craniocerebral injury,may resulting from the humoral regulation of naloxone.

OBJECTIVETo investigate the influence of the polluted SY River on children's growth and sex hormones, and provide scientific data for assessment of the polluted status of the SY River.

METHODSThe study areas were selected randomly from the SY River Basin. Lead (Pb), mercury (Hg), arsenic (As), phthalates (DEP, DBP, DMP, DEHP), and bisphenol A (BPA) were measured both in the river water and in the drinking water. School children were selected by cluster sampling (n=154). Physical development indexes (height, weight, bust-circumference, and skinfold thickness) and sex hormones [testosterone (T) and estradiol (E2)] were measured for all the children.

RESULTSThe contents of Pb and Hg exceeded Class V standards of surface water quality in each section of the river and other indicators exceeded Class III. Compared to the control area, the concentrations of Pb, Hg, As, BPA, DEP, and DBP in the drinking water were significantly higher than in the polluted area (P<0.05). Children from the control area had significantly lower E2 and T than children from the polluted area (P<0.05). Among anthropometric results, only skinfold thickness had statistically significant difference between the two groups (P<0.05), while the other indexes showed no significant differences between the two groups (P>0.05).

CONCLUSIONThe drinking water has been polluted by the SY River and affected serum sex hormone levels of children living in the polluted area.

Adolescent ; Adolescent Development ; drug effects ; Child ; Child Development ; drug effects ; China ; Female ; Gonadal Steroid Hormones ; metabolism ; Humans ; Male ; Rivers ; chemistry ; Water ; chemistry ; Water Pollutants, Chemical ; toxicity ; Water Pollution, Chemical ; adverse effects ; Water Supply ; analysis